Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.20 / $61.80 / $122.25	Facility		$55.20	$61.80	$122.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.60 / $83.70 / $233.17	Professional		$56.60	$83.70	$233.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.59 / $98.93 / $134.47	Professional		$76.59	$98.93	$134.47
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $74.34 / $79.54 / $85.04	Professional		$74.34	$79.54	$85.04
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $8,639.91 / $79,506.39	Facility		$5,000.00	$8,639.91	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $80.67 / $114.26 / $158.19	Professional		$80.67	$114.26	$158.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.96 / $91.96 / $91.96	Facility		$91.96	$91.96	$91.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.94 / $88.89 / $132.97	Professional		$66.94	$88.89	$132.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $43.00 / $92.73 / $155.94	Professional		$43.00	$92.73	$155.94
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $78.95 / $78.95 / $78.95	Facility		$78.95	$78.95	$78.95
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.45 / $88.92 / $130.22	Professional		$78.45	$88.92	$130.22
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $74.34 / $79.65 / $130.33	Professional		$74.34	$79.65	$130.33
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $55.20 / $58.92 / $97.92	Facility		$55.20	$58.92	$97.92
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $58.42 / $87.42 / $181.30	Professional		$58.42	$87.42	$181.30
Optum Facility/Professional Professional Modifier Low / Median / High Price $80.98 / $85.04 / $95.00	Professional		$80.98	$85.04	$95.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $74.90 / $114.15 / $154.68	Professional		$74.90	$114.15	$154.68
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $91.96 / $91.96 / $91.96	Facility		$91.96	$91.96	$91.96
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $66.11 / $87.70 / $137.74	Professional		$66.11	$87.70	$137.74
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $76.31 / $78.87 / $78.87	Facility		$76.31	$78.87	$78.87
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $64.80 / $78.87 / $82.35	Professional		$64.80	$78.87	$82.35
United Facility/Professional Professional Modifier Low / Median / High Price $62.26 / $83.55 / $135.11	Professional		$62.26	$83.55	$135.11